Star Health Comprehensive Insurance

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Senior citizens above 60 years need not have to be anxious about health care and financial assistance to pay medical bills. This insurance covers anyone above 60 years and permits entry upto the age of 75 with continuing cover after that.

Up to 10% of the sum insured per policy period. Applicable for sum insured Rs.7.50 Lakhs and above only.

Emergency ambulance charges for transporting the insured patient to the hospital up to limits mentioned in the benefit table.

Pre-existing Disease

Pre existing diseases are covered after 48 months of continuous insurance with the any Indian Insurance Company.

Pre & Post Hospitalization

pre-hospitalization medical expenses up to 30 days prior to the date of admission in the hospital.

post-hospitalization medical expenses up to 60 days after discharge from the hospital.

Delivery and New-Born cover

Expenses for Delivery: Normal delivery or by Cesarean section.

Treatment of the new born baby.

Vaccination for Children : Up to Rs.1,000.

Day Care Treatment

405 day care treatments are allowed.

Health Check up

The benefit is payable on continuous coverage of a block of every 3 claim free years.

Co Pay

10% of each and every claim made by insured persons who are above 60 years at entry level.

Tax benefits

Payment by any mode other than cash for insurance is eligible for relief under section 80D of the Income Tax Act.

Benefits table

Benefits(Sum Insured in INR)

5 Lakhs

7.50 Lakhs

10 Lakhs

15 Lakhs

20 Lakhs

25 Lakhs

Room Rent (single a/c room)

Actual

Actual

Actual

Actual

Actual

Actual

ICU/Operation Theater Charges

Actual

Actual

Actual

Actual

Actual

Actual

Ambulance Charges - Per Policy Period

Up to Rs.2,000

Up to Rs.3,000

Up to Rs.3,500

Up to Rs.4,000

Up to Rs.4,500

Up to Rs.5,000

Pre hospitalization

30 days

30 days

30 days

30 days

30 days

30 days

Post hospitalization

60 days

60 days

60 days

60 days

60 days

60 days

Delivery Coverage - normal Delivery

Up to Rs.10,000

Up to Rs.20,000

Up to Rs.25,000

Up to Rs.25,000

Up to Rs.25,000

Up to Rs.25,000

Waiting Period for Delivery

36 months

36 months

36 months

36 months

36 months

36 months

Coverage for New Born Child
(Subject to a terms and conditions)

Up to Rs.50,000

Up to Rs.1,00,000

Up to Rs.1,00,000

Up to Rs.1,00,000

Up to Rs.1,00,000

Up to Rs.1,00,000

Vaccination expenses for New Born
(Subject to a terms and conditions)

Up to Rs.1,000

Up to Rs.1,000

Up to Rs.1,000

Up to Rs.1,000

Up to Rs.1,000

Up to Rs.1,000

OP Dental / Opthal Coverage

Up to Rs.5,000

Up to Rs.5,000

Up to Rs.10,000

Up to Rs.10,000

Up to Rs.10,000

Up to Rs.10,000

Cover for Accidental Death and Permanent Total Disablement

Rs.5,00,000

Rs.7,50,000

Rs.10,00,000

Rs.15,00,000

Rs.20,00,000

Rs.25,00,000

Hospital cash 7 days per occurrence & 120 days per policy period(1 day time excess)

Rs 500/day

Rs 750/day

Rs 750/day

Rs 1000/day

Rs 1000/day

Rs 1500/day

Health check up once in a block of every 3 claim free years of continuous renewal

Up to Rs.5,000

Up to Rs.7,500

Up to Rs.7,500

Up to Rs.12,000

Up to Rs.12,000

Up to Rs.12,000

Restoration benefit after exhaustion of sum insured

100%

100%

100%

100%

100%

100%

3 months to 65 years are eligible to buy this policy.

Guaranteed renewal for life time.

No exit age

Eligibility

Cover can be given to HIV + persons whose CD 4 count is not less than 350 at entry point.

No claim payable for Opportunistic infections.

No claim for treatment of HIV / AIDS.

All expenses incurred in connection with treatment of any disease/illness/condition which is pre-existing at the time of commencement of insurance.

Treatment of disease/sickness/illness contacted by the Insured Person during the first 30 days from the commencement date of the policy.

Expense incured in the first two years of continuous operation of insurance cover on treatment of Cataract, Hysterectomy for Menorrhagia or Fibromyoma, Knee replacement surgery (other than caused by an accident) Joint Replacement Surgery (other than caused by accident), Prolapse of intervertebral disc (other than caused by accident), Varicose veins and Varcose ulcers.

Expense incured during the first year of operation of the insurance treatment of diseases such as Bengin Prostate Hypertrophy, Hernia, Hydrocele, Fistula in anus, Piles, Sinusitis and related disorders, gallstones and renal stone removal.

Circumcision unless necessary for treatment of disease not excluded hereunder or as may be necessitated due to an accident, vaccination (except for post bite treatment.), inoculation or change of life or cosmetic or aneshetic treatment, plastic surgery other than as may be necessitated due to an accident or as part of my illness.

Treatment of Congenital external disease/defects/anomalies.

Cost of spectacles, hearing aids, walkers crutches and similar aids.

Dental treatments unless following accidental injuries.

Renewal will not be normally refused except on grounds such as fraud, moral hazard or misrepresentation. Where the claim ratio for the proceding 2 consecutive years exceeds 100%, premium loading as per the table given below would be applicable.

Claim under Delivery and New Born Section, Dental and Opthalmic treatment will not be taken for loading purpose.
A grace period of 15 days from the date of expiry of the policy is available for renewal. If renewal is made within 15 days period the continuity of benefits will be allowed. However the actual period of cover will start only from the date of payment of premium. In other words no protection is available between the policy expiry date and the date of payment of premium for renewal.